Provider Demographics
NPI:1215027974
Name:DRYDEN-MINGER, NOEL A (MS, LLP)
Entity Type:Individual
Prefix:
First Name:NOEL
Middle Name:A
Last Name:DRYDEN-MINGER
Suffix:
Gender:F
Credentials:MS, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9464 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:GOODRICH
Mailing Address - State:MI
Mailing Address - Zip Code:48438-9285
Mailing Address - Country:US
Mailing Address - Phone:810-636-2071
Mailing Address - Fax:
Practice Address - Street 1:10785 S SAGINAW ST
Practice Address - Street 2:BLDG. E, SUITE A
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7003
Practice Address - Country:US
Practice Address - Phone:810-695-0055
Practice Address - Fax:810-695-6813
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301008610103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical